Abstract：
Children with asthma who live in urban neighborhoods experience a disproportionately high asthma burden, with increased incident asthma and increased asthma symptoms, exacerbations, and acute visits and hospitalizations for asthma. There are multiple urban exposures that contribute to pediatric asthma morbidity, including exposure to pest allergens, mold, endotoxin, and indoor and outdoor air pollution. Children living in urban neighborhoods also experience inequities in social determinants of health, such as increased poverty, substandard housing quality, increased rates of obesity, and increased chronic stress. These disparities then in turn can increase the risk of urban exposures and compound asthma morbidity as poor housing repair is a risk factor for pest infestation and mold exposure and poverty is a risk factor for exposure to air pollution. Environmental interventions to reduce in-home allergen concentrations have yielded inconsistent results. Population-level interventions including smoking bans in public places and legislation to decrease traffic-related air pollution have been successful at reducing asthma morbidity and improving lung function growth. Given the interface and synergy between urban exposures and social determinants of health, it is likely population and community-level changes will be needed to decrease the excess asthma burden in children living in urban neighborhoods.
摘要：
居住在城市社区的哮喘儿童经历了不成比例的高哮喘负担，随着哮喘事件的增加和哮喘症状的增加，恶化,以及哮喘的急性就诊和住院。有多种城市暴露导致小儿哮喘发病率，包括接触害虫过敏原，霉菌,内毒素,室内和室外空气污染。生活在城市社区的儿童在健康的社会决定因素方面也存在不平等，比如贫困加剧，不合格的住房质量，肥胖率增加，增加慢性压力。这些差异反过来会增加城市暴露和复合哮喘发病率的风险，因为住房修复不良是虫害和霉菌暴露的风险因素，而贫困是暴露于空气污染的风险因素。降低家庭过敏原浓度的环境干预措施产生了不一致的结果。包括公共场所禁烟和减少交通相关空气污染的立法在内的人口干预措施已成功降低了哮喘的发病率并改善了肺功能的生长。鉴于城市暴露与健康的社会决定因素之间的界面和协同作用，可能需要在人口和社区层面进行改变,以减轻居住在城市社区的儿童的过度哮喘负担.
